San Francisco VA Medical Center - Downtown Clinic
401 Third Street @ Harrison Street, 94107 415-281-5100 (Main Number) 415-281- 5103 (Mental Health Outpatient Services) 415-281-5101 (Social Work Services) 415-281-5105 (Compensated Work Therapy) 415-281-5190 (HUD/VASH) http://www.sf.med.va.gov (Website) http://www.myhealth.va.gov (Website) M-F: 8am - 4:30pm Medical Clinic Provides veterans primary medical care, laboratory services, physicals, immunizations, social work, referrals and specialty services, health screening and education, pharmacy, and medical advice nurse. Also, social service referrals, health maintenance and promotion, group education and counseling, and VA benefits assistance are provided for homeless veterans. Mental Health Outpatient Services Provides veterans psychiatric outpatient care, intensive psychiatric community care, substance abuse services, group and individual counseling, and PTSD treatment. Health care for Homeless Veterans Social Work evaluation, referrals and counseling Daily drop-in clinic • Psychiatric Evaluation Medical screening including linkage to Downtown Clinic primary care VA benefit assistance through County Service Veterans Office on-site biweekly or by referral 2013-2014 HAP Manual Updates Health Care for Homeless Veterans – Compensated Work Therapy/Transitional Residence (CWT/TR) - G 401 3rd St., 94107 SFVAMC Downtown Clinic, CWT Program Coordinator 415-281-5105 415-861-2008 (Fax) M–F: 8:00-4:30 The Program is designed to help veterans make the transition from homelessness to independent employment and community living. The program provides case management and vocational experience in a workshop or transitional work placement. Veterans are required to be clean and sober and should be referred by their case manager or outpatient treatment provider. Category:Alcohol and Drug Abuse / Methadone Maintenance Category:Employment Assistance / Job Training Category:Medical & Health Category:Mental Health / Counseling Category:Veterans Emergency housing and treatment referrals Emergency Housing Shelter beds at Next Door Shelter in San Francisco Contract beds at Walden House (Drug and Alcohol TX), Fresh Start (Homeless, Clean and Sober) and DeMontfort Program (Mental Health Stabilization) in San Francisco Contract beds at Turning Point in Santa Rosa and Center Point in Marin, North Coast Veteran Resource Center in Eureka Grants and Per Diem Program VA partners with community agencies to provide up to 2 years transitional housing and support services. Clean and sober living environments Programs provide varying levels of treatment. The goal is to help Veterans achieve residential stability. VA Supported Housing Partnership between VA and HUD Housing First model Case management and support services Exclusions: registered sex offenders and over income limits National Call Center for Homeless Veterans - 1-877-4AID VET /1-877-424-3838 Hotline 24 hours a day/ 7 days a week Resources and support for Veterans, family members and community agencies Coordinated access to VA and community services Veteran Justice Outreach Engage and link Justice involved Veterans to VA who are in jail. Jail outreach liaison to Court and Collaborative Courts systems Education to the San Francisco Police Department on issues related to Veterans such as PTSD and Traumatic Brain Injury (TBI) Homeless Outreach Coordinator Engage _and link homeless Veterans in community, streets, parks, soup kitchens etc. to VA services • Educate VA staff and community partners about VA services Coordinate homeless Veteran services with community providers including outreach teams, Police~ etc. Coordinate with Rural Health, Veterans Justice Outreach and other VA Outreach Health Care for Homeless Veterans Program Handbook, January 2012 Compensated Work Therapy - mployment planning and placement to strengthen job skills. Case management Transitional Residences to prepare Veterans for independent living. ' Homeless Veteran Supported Employment Program -' to provide vocational assistance, job development, job placement and ongoing employment support. Health Care for Homeless Veterans PROGRAM HANDBOOK San Francisco VA Medical Center Downtown Clinic 401 3rd St, San Francisco, CA 94107 415-281-5101 Health Care for Homeless Veterans (HCHV) MISSION The mission of HCHV is to identify and engage veterans who are homeless or marginally housed and who underutilize VA services. By linking veterans with appropriate treatment and social services, our goal is to increase stability in veterans’ lives and assist veterans in returning to independent, healthy and productive lifestyles. HCHV realizes that each veteran comes to us with a unique experience and set of circumstances and must work toward his/her goals at his/her own pace. Keeping this in mind, referrals and treatment plans are always individualized and specific to each veteran’s needs. We are dedicated to ending Veteran Homelessness. VISION Our vision is to be a model of excellence in homeless services, driven by commitment, compassion, and the needs of the veterans we serve. VALUES Respect: To always show consideration, high regard, and courtesy to our veterans, their families, our co- workers, and the community at-large. Diversity: To value and respect differences in ethnicity, culture, sexual orientation, gender, disability status as well as respect for differing personal, spiritual, religious and political values. Commitment: To pledge to give our best effort in the provision of services to our veterans and to stay true to our vision and mission. Excellence: To take pride in our work and provide the highest quality of services possible. Flexibility: To focus on teamwork and getting the job done. Accessibility: To always be aware of potential barriers and remove them whenever possible. Client-focused: To obtain input from those we serve and to always address the needs of our clients. Health Care for Homeless Veterans (HCHV) is a treatment service center, providing assessment and referral for homeless and marginally housed veterans. We are part of the San Francisco VA Medical Center. Drop-in services are available on a daily basis from 8 am until noon, and in the afternoon by appointment. If you are ineligible for VAMC services, you will be given referrals to appropriate community resources. Assessment and Referral What is Assessment and Referral? Assessment and Referral at HCHV are comprehensive services offered to veterans. The assessment process begins when you come in the front door. Our staff assists you in determining your eligibility for services. You will see a social worker who completes a psychosocial assessment determining your strengths, needs, resources, and support systems. The referral process begins as soon as the assessment is complete. The goal is to give you tangible resources and environmental change that will support your long term goals, as well as provide services that fit your age and your culture. HCHV Assessment and Referral functions include the following: • Client identification, outreach, and engagement • Assessment to determine strengths and barriers to meeting goals. • Linkage to needed resources (i.e. VAMC, community social services, housing) • Monitoring, ongoing evaluation and follow- up • Advocacy to ensure equity and appropriateness for the client • Crisis intervention Who receives Assessment and Referral at HCHV? Any eligible veteran, who is homeless or marginally housed, and requests our assistance in accessing services and resources for change. How long is Assessment and Referral? Assessment and Referral is a flexible and dynamic process offering you support and follow-up to assure your needs are met. We encourage veterans to consult with community agency case managers and providers to coordinate care and minimize duplication of services. HCHV Services • DAILY Drop-in Clinic, Monday through Friday, 8:00-12:00pm. This does not preclude you from accessing HCHV services in the afternoon, however services are more limited as social workers are working with Veterans from morning clinic, are on outreach, and are assisting Veterans in the community. • Social Work Assessment and Referral, including follow-up and crisis intervention. We offer a range of assessment, information, crisis, linkage, advocacy, referral, and follow-up services. • Psychiatric Evaluation, medication stabilization and follow-up. • Medical Screening and linkage to specialized medical clinics, as well as referral to Downtown Clinic primary care. • VA Benefits Assistance through CVSO onsite bi-weekly or by referral. • Support Groups are available daily, check posted group schedules. • Showers are available daily on a first come, first served basis. Towels and soap are supplied. • Laundry is available daily on a first come, first served basis. • Lockers are available for short term storage of belongings, as locker space is open. You must sign a locker contract to be approved. • Transportation is provided by the VAMC shuttle van to and from the SF VA Medical Center several times per day. Additional transportation assistance is available on a limited basis for verified appointments and must be approved by your social worker. • Mail Service is offered Monday through Friday. • Free Telephone Access is provided in our clinic for time-limited local calls. Long distance calls must be approved through your social worker. • Community Outreach and Education is provided by HCHV staff, who visit various community programs, participate in a number of community groups and committees, and are involved with special projects that help educate the public. Entrance Requirements To be Eligible for HCHV you must be: 1. An Eligible veteran* 2. Homeless or at risk of becoming homeless 3. Currently underutilizing VA services 4. Willing to work with a Social Worker *Member Services determines eligibility, staff determines appropriateness for services. Veterans not eligible for VA services, such as having a dishonorable discharge from the military, will be seen briefly and referred to appropriate resources. An ineligible veteran may still be eligible for Grant and Per Diem funding, see “Other VA Programs” section in this Handbook. Discharge Veterans are discharged from HCHV based on the following: 1. Successful completion of goals 2. Repeated non-compliance or lack of follow-up with referrals* 3. Repeated behavioral problems* *Discharges under these conditions require approval by CHC Supervisor, HCHV Coordinator and/or Administrative Site Manager Follow-Up We encourage you to let us know how the resources and referrals did or did not work out for you so that we can continue to provide quality services. COMMUNITY PARTNERS We partner with many community agencies and organizations to provide comprehensive specialized services that meet your needs. A few of these partners are: 1. Swords to Plowshares, 252-4788, 1060 Howard St, SF 2. County Veterans Service Office, 503-2000, 27 B Van Ness Ave, SF 3. Vet Center, 441-5051, 505 Polk St, SF 4. San Francisco Community Behavioral Health Services, Central Access, 415-255-3737 OTHER VA PROGRAMS You may also be referred to other VA programs. A few of the VA partners are: 1. The VA Grant and Per Diem Program - VA funding for community based care for substance abuse residential treatment and transitional housing from San Francisco to Eureka. 2. Substance Abuse Day Hospital and Drug & Alcohol Treatment Program – VAMC based outpatient programs to help you get and stay clean and sober. 3. Compensated Work Therapy/Transitional Work Employment/Supported Employment – Work therapy for veterans who need a transitional work program to assist them to begin to re-enter the workforce. 4. OEF/OIF Program – Case management and support for veterans recently separating from service. 5. HUD/VASH program – Voucher program CLINIC and VETERAN SAFETY Emergencies In the event of an emergency or disaster, please remain calm and follow staff instructions. While you are visiting the Downtown Clinic, you may be asked to participate in an emergency disaster drill. Please follow staff instructions. We make every attempt to minimize inconvenience to you, but wish to make this a safe place. Personal Safety You may always request to see a Social Worker or VA staff at the Downtown Clinic to assist in making yourself safe. The National Suicide Hotline is 1-800-273-TALK (8255). Calling this number provides you with access to trained telephone counselors, 24 hours a day, 7 days a week. Rules of Behavior Veterans and visitors to the Downtown Clinic are asked to abide by rules governing behavior in the clinic. These rules include: 1. No weapons, alcohol, or drugs are to be brought onto the premises. 2. No verbal or physical abuse is tolerated. This includes behavior and language that is considered derogatory, threatening, intimidating, or aggressive. 3. No behaviors that disrupt clinic function such as yelling, banging doors or furniture, or disrobing. 4. Veterans under the influence of drugs and/or alcohol and who are unruly are not allowed in the facility. 5. No pets are allowed in the facility (this does not apply to service animals or registered companion animals – These animals must be under the control of the Veteran). 6. When veterans bring friends or family to the facility, the non-veterans are expected to follow these rules. 7. No smoking in the facility. Those individuals who do not abide by the behavioral rules will be asked to leave the facility immediately or risk suspension or permanent ban from use of this facility, as well as possible police intervention. Depending upon the seriousness of the incident and level of risk it represents, veterans who violate the above rules may have their name and the nature of the incident forwarded to the Behavioral Alert Review Committee (BARC), who will determine consequences. Suspension Guidelines: 1. Verbal offenses: A. First offense – verbal warning and/or warning letter. B. Second offense – Veteran will be asked to leave the clinic for a few days as a cooling off period and BARC notification. C. Third offense – Behavioral contract and clinic participation with Security supervision. D. Fourth offense - staff review, possible prohibition from utilizing the clinic and BARC review. E. Documentation of the warning and/or content of the written warning in the veteran’s medical record. 2. Serious verbal threats such as threats of bodily harm or bomb threats: Such threats are taken very seriously and will result in police involvement and immediate suspension with likely discharge from the program following staff review and BARC recommendations. 3. Physical offenses: This will result in an immediate suspension at minimum, possible prohibition from utilizing the services of the clinic, possible police arrest, and/or BARC review. CONFLICT RESOLUTION A conflict is when you disagree with what someone has said or with what someone has done. Many times, the conflict is due to poor communication between both parties. If you have a conflict with someone, the following are suggestions on how to handle your feelings and the situation: • Try to remove yourself from the conflict by getting up and walking around. If asked what you are doing, just reply that you need time to calm down. • Take deep breaths to help calm yourself. • When you feel you can talk to the person you had the conflict with, tell them how you are feeling. • If you do not feel you can talk to the person you had a conflict with that day then talk with an HCHV Social Worker or VA staff about your feelings. Talk about the specific behavior that has upset you. Remember, most conflicts involve poor communication between both parties so don’t just blame the other person. Look and see what you could have done differently. GRIEVANCE PROCESS A grievance is a situation where you feel your rights have been denied or something has happened that you believe is unfair and you want to make a complaint. Feedback, in general, is an important part of the program and we encourage you to use the suggestion boxes, as well as individual and group meetings, to share ideas for program improvement. • Good solutions to grievances are always based on good communication. • It is important to use the grievance process to resolve problems in the program. • No retaliation will happen to you because you make a grievance, and it will not be harder to get any service because you make a grievance. • Grievances are most easily resolved when both parties are calm and in control of their feelings. Talk to the person(s) involved first. If the situation is not resolved, go to the first person in the chain of command. If the problem is still not resolved, follow the chain below. • You can expect a resolution to your problem within five working days. Unless you request otherwise, responses will be verbal. Follow the steps below to resolve a grievance at the Downtown Clinic: FIRST STEP SECOND STEP THIRD STEP Remain calm. You may want to write out what has happened to be sure you understand how things came to be the way they are. If you are angry, it is best to wait until you are calm before you try to "talk things out". Talk to the person or persons involved. Don't assume they know what happened or that they mean what you think they mean. Discuss your thoughts and feelings calmly and clearly. Have a solution or an answer to the problem in mind. Use the chain of command. Talk to the first person in the chain to solve the problem before you go on to the next person. Concerns regarding: Medical Service – FIRST – Physician SECOND – Medical Director CWT/TR – FIRST- House manager SECOND – CWT/TR Coordinator HCHV - FIRST- Social Worker on duty SECOND- CHC Supervisor Mental Health – FIRST – Mental Health Provider SECOND – Mental Health Director Nursing – FIRST-Provider SECOND-Charge Nurse If not resolved, continue to Second Step If person does not respond within 5 working days and/or it is not resolved, continue to Third Step If staff does not respond within 5 working days and/or it is not resolved, continue to Fourth Step FOURTH STEP FINAL STEP Make an appointment to see the Administrative Site Manager, Anita Yoskowitz, 415.281.5109 If you have gone through these channels and you feel the situation is still not resolved, make an appointment to see the Patient Representative at the VA Medical Center 221-4810, x6650. If staff does not respond within 5 working days and/or it is not resolved, continue to Final Step VHA PATIENT RIGHTS AND RESPONSIBILITIES The Veterans Health Administration (VHA) is pleased you have selected us to provide your healthcare. We want to improve your health and well-being. We will make your visit or stay as pleasant for you as possible. As part of our service to you, to other veterans and to the Nation, we are committed to improving healthcare quality. We also train future healthcare professionals, conduct research, and support our country in times of national emergency. In all of these activities, our employees will respect and support your rights as a patient. Your basic rights and responsibilities are outlined in this document. Please talk with VA treatment team members or a patient advocate if you have any questions or would like more information about your rights. I. Respect and Nondiscrimination • You will be treated with dignity, compassion, and respect as an individual. Your privacy will be protected. You will receive care in a safe environment. We will seek to honor your personal and religious values. • You or someone you choose has the right to keep and spend your money. You have the right to receive an accounting of any VA held funds. • Treatment will respect your personal freedoms. In rare cases, the use of medication and physical restraints may be used if all other efforts to keep you or others free from harm have not worked. • As an inpatient or nursing home resident, you may wear your own clothes. You may keep personal items. This will depend on your medical condition. • As an inpatient or nursing home resident, you have the right to social interaction and regular exercise. You will have the opportunity for religious worship and spiritual support. You may decide whether to participate in these activities. You may decide whether or not to perform tasks in or for the Medical Center. • As an inpatient or nursing home resident, you have the right to communicate freely and privately. You may have or refuse visitors. • You will have access to public telephones. You may participate in civic rights, such as voting and free speech. • As a nursing home resident, you can organize and take part in resident groups in the facility. Your family also can meet with the families of other residents. • In order to provide a safe treatment environment for all patients or residents and staff, you are expected to respect other patients, residents and staff and to follow the facility’s rules. Avoid unsafe acts that place others at risk for accidents or injuries. Please immediately report any condition you believe to be unsafe. • You, and any persons you choose, will be involved in all decisions about your care. You will be given information you can understand about the benefits and risks of treatment. You will be given other options. You can agree to or refuse treatment. You will be told what is likely to happen to you if you refuse treatment. Refusing treatment will not affect your rights to future care but you take responsibility for the possible results to your health. • Tell your provider about your current condition, medicines (including over-the-counter and herbals), and medical history. Also, share any other information that affects your health. You should ask questions when you do not understand something about your care. Being involved is very important for you to get the best possible results. • You will be given, in writing, the name and title of the provider in charge of your care. As our partner in healthcare, you have the right to be involved in choosing your provider. You also have the right to know the names and titles of those who provide you care. This includes students, residents and trainees. Providers will properly introduce themselves when they take part in your care. • You will be educated about your role and responsibilities as a patient or resident. This includes your participation in decision making and care at the end of life. • If you believe you cannot follow the treatment plan, you have a responsibility to notify your provider or treatment team. • You have the right to have your pain assessed and to receive treatment to manage your pain. You and your treatment team will develop a pain management plan together. You are expected to help the treatment team by telling them if you have pain and if the treatment is working. • As an inpatient or nursing home resident, you will be provided any transportation necessary for your treatment plan. • You have the right to choose whether you will participate in any research project. Any research will be clearly identified. Potential risks of the research will be identified and there will be no pressure on you to participate. • You will be included in resolving any ethical issues about your care. You may consult with the Medical Center’s Ethics Consultation Service and/or other staff knowledgeable about healthcare ethics. • If you or the Medical Center believes that you have been neglected, abused or exploited, you will receive help. II. Information Disclosure and Confidentiality • You will be given information about the health benefits you can receive. The information will be provided in a way you can understand. • You will receive information about the costs of your care, if any, before you are treated. You are responsible for paying your portion of any costs associated with your care. • Your medical record will be kept confidential. Information about you will not be released without your consent unless authorized by law (an example of this is State public health reporting). You have the right to information in your medical record and may request a copy of your medical records. This will be provided except in rare situations when your VA physician feels the information will be harmful to you. In that case, you have the right to have this discussed with you by your VA provider. • You will be informed of all outcomes of care, including any potential injuries. You will be informed about how to request compensation for any injuries. III. Participation in Treatment Decisions • You, and any persons you choose, will be involved in all decisions about your care. You will be given information you can understand about the benefits and risks of treatment. You will be given other options. You can agree to or refuse treatment. You will be told what is likely to happen to you if you refuse treatment. Refusing treatment will not affect your rights to future care but you take responsibility for the possible results to your health. • Tell your provider about your current condition, medicines (including over-the-counter and herbals), and medical history. Also, share any other information that affects your health. You should ask questions when you do not understand something about your care. Being involved is very important for you to get the best possible results. • You will be given, in writing, the name and title of the provider in charge of your care. As our partner in healthcare, you have the right to be involved in choosing your provider. You also have the right to know the names and titles of those who provide you care. This includes students, residents and trainees. Providers will properly introduce themselves when they take part in your care. • You will be educated about your role and responsibilities as a patient or resident. This includes your participation in decision making and care at the end of life. • If you believe you cannot follow the treatment plan, you have a responsibility to notify your provider or treatment team. • You have the right to have your pain assessed and to receive treatment to manage your pain. You and your treatment team will develop a pain management plan together. You are expected to help the treatment team by telling them if you have pain and if the treatment is working. • As an inpatient or nursing home resident, you will be provided any transportation necessary for your treatment plan. • You have the right to choose whether you will participate in any research project. Any research will be clearly identified. Potential risks of the research will be identified and there will be no pressure on you to participate. • You will be included in resolving any ethical issues about your care. You may consult with the Medical Center’s Ethics Consultation Service and/or other staff knowledgeable about healthcare ethics. • If you or the Medical Center believes that you have been neglected, abused or exploited, you will receive help. IV. Complaints • You are encouraged and expected to seek help from your treatment team or a patient advocate if you have problems or complaints. You will be given understandable information about the complaint process. You may complain verbally or in writing, without fear of retaliation. CARF Health Care for Homeless Veterans is a CARF accredited program. CARF-accredited programs and services have demonstrated that they substantially meet internationally recognized standards. CARF accreditation means that you can be confident that an organization has made a commitment to continually enhance the quality of its services and programs, and its focus is on consumer satisfaction. If you feel the HCHV program fails to meet these standards, complaints can be directed to the CARF toll-free telephone number by calling 1-888-281-6351. Request to speak with the Director of Employment and Community Services. You have the right to report without fear of retribution for making a complaint. For more information on HCHV and other services, please contact a VA staff person at the clinic. We are glad you are here. Category:Alcohol and Drug Abuse / Methadone Maintenance Category:Employment Assistance / Job Training Category:Medical & Health Category:Mental Health / Counseling Category:Veterans Category:Needs Clean Up